In sub-Saharan Africa, 56 million children have lost a parent. As these orphans reach adolescence, there is mounting concern that they may be experiencing heightened levels of sexual victimization, risky sexual behavior, and STD transmission. The little available research on orphan sexual disparities, however, lacks the technical rigor, geographic scope and consistency needed to draw broad programmatic and policy conclusions. Moreover, there has been almost no investigation of the modifiable pathways by which orphan disparities form or the factors that create resilience. The proposed study will address these gaps through the analysis of 34 existing Demographic and Health Surveys in 22 sub-Saharan Africa countries and has the following specific aims: Aim 1) To test whether orphanhood is a risk factor for adverse sexual outcomes, including sexual violence, high risk sexual behaviors and STD infection. Although orphan disadvantage is often assumed, there is a glaring lack of evidence in support. Our findings will improve scientific knowledge by examining the existence and geographic consistency of disparities. Aim 2) To simultaneously test multiple pathways between orphanhood and the above adverse sexual outcomes. We propose a conceptual framework that will allow us to identify the most salient pathways, and thus guide the development of appropriate prevention programs for orphans. Aim 3) To identify protective factors that moderate the association between orphanhood and the above adverse sexual outcomes. Although most research and policy focuses on orphan disadvantage, many orphans successfully navigate difficult circumstances and engage in sexually healthy behaviors. We will investigate protective individual assets and family resources that moderate risk and that may be strengthened through future intervention. Thus, the proposed study will advance the field by providing rigorous, generalizable evidence on the sexual health of adolescent orphans living in resource- deprived areas. Importantly, there is already substantial commitment from humanitarian groups, governments, and donors to improve the welfare of orphaned adolescents. This represents a critical window of opportunity: strong evidence can be immediately leveraged to generate new programmatic initiatives to improve sexual health among this marginalized population.